Processes

What will AGI do for Create claims imaging and record within claims system?

A health insurance claim document is received from a medical provider or policyholder via mail, fax, or electronic submission.

Trigger: A health insurance claim document is received from a medical provider or policyholder via mail, fax, or electronic submission.
Outcome: A fully digitized and indexed claim record, complete with attached original document images, is established in the core claims system and routed for adjudication.

The work itself

Grounded Work Profile

Receive physical or electronic claim documentsprocessProfile
Scan paper claims and ingest digital filesprocessProfile
Extract claim data using optical character recognition and data mappingprocessProfile
Validate extracted fields against provider and member databasesprocessProfile
Generate a digital claim record within the core administration systemprocessProfile
Index and link the source document image to the new claim recordprocessProfile
Route the digital claim record to the adjudication queueprocessProfile

How AGI delivers it

Autonomous Agents as digital employees
Hire a digital employee that does the job under earned, supervised autonomy.
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Services-as-Software
Get the professional outcome delivered as software, priced on results, not headcount.
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Business-as-Code
Encode how your work runs, once, as software that executes itself.
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Value flow

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